title: Differences in the availability of new anti-cancer drugs for Italian patients treated in different regions. Results of analysis conducted by the Italian Society Of Medical Oncology (AIOM).
abstract: OBJECTIVE
  Italy is divided into 20 regions. As a consequence of local autonomy, following marketing authorization by the Italian Medicines Agency, each drug for hospital use is not immediately available, because its approval needs to undergo further steps that can be different among regions. The Italian Society of Medical Oncology conducted the present study to describe the impact of the existence of sub-national pharmaceutical formularies on the disparity of access to new anti-cancer drugs among patients treated in different Italian regions.
  
  
  METHODS
  The availability of 8 new anti-cancer drugs at a regional level and the coherence of regional authorizations compared with national authorizations approved by the Italian Medicines Agency were analyzed as of April 2009.
  
  
  RESULTS
  Fourteen regions and autonomous province of Trento have a regional pharmaceutical formulary. In most cases, the regional pharmaceutical formularies include the eight analyzed drugs, with therapeutic indications coherent with national marketing authorization indications. Five drugs (bevacizumab, trastuzumab, rituximab, erlotinib, sunitinib) were included in all the existing regional pharmaceutical formularies, without restrictions, whereas three drugs (cetuximab, sorafenib, pemetrexed) were found to have restrictions in some regions.
  
  
  CONCLUSIONS
  The presence of multiple hierarchical levels of drug evaluation creates a potential element of disparity in the access to pharmacological therapies for Italian citizens.
authors.affiliation: Medical Oncology SM della Misericordia Hospital, Azienda Ospedaliera, Perugia, Italy. stefania.gori@tin.it
authors.forename: Stefania
authors.initials: S
authors.lastname: Gori
authors.forename: Massimo
authors.initials: M
authors.lastname: Di Maio
authors.forename: Carmine
authors.initials: C
authors.lastname: Pinto
authors.forename: Oscar
authors.initials: O
authors.lastname: Alabiso
authors.forename: Editta
authors.initials: E
authors.lastname: Baldini
authors.forename: Giordano Domenico
authors.initials: GD
authors.lastname: Beretta
authors.forename: Orazio
authors.initials: O
authors.lastname: Caffo
authors.forename: Cinzia
authors.initials: C
authors.lastname: Caroti
authors.forename: Lucio
authors.initials: L
authors.lastname: Crinò
authors.forename: Michelino
authors.initials: M
authors.lastname: De Laurentiis
authors.forename: Angelo
authors.initials: A
authors.lastname: Dinota
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Vito
authors.forename: Vittorio
authors.initials: V
authors.lastname: Gebbia
authors.forename: Lucio
authors.initials: L
authors.lastname: Giustini
authors.forename: Claudio
authors.initials: C
authors.lastname: Graiff
authors.forename: Michele
authors.initials: M
authors.lastname: Guida
authors.forename: Giorgio
authors.initials: G
authors.lastname: Lelli
authors.forename: Marco
authors.initials: M
authors.lastname: Lombardo
authors.forename: Antonio
authors.initials: A
authors.lastname: Muggiano
authors.forename: Fabio
authors.initials: F
authors.lastname: Puglisi
authors.forename: Sante
authors.initials: S
authors.lastname: Romito
authors.forename: Luigi
authors.initials: L
authors.lastname: Salvagno
authors.forename: Pierosandro
authors.initials: P
authors.lastname: Tagliaferri
authors.forename: Edmondo
authors.initials: E
authors.lastname: Terzoli
authors.forename: Marco
authors.initials: M
authors.lastname: Venturini
mesh_terms: D000970:Antineoplastic Agents / Q000600:supply & distribution* / Q000627:therapeutic use; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D005569:Formularies as Topic; D019538:Health Care Surveys; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy; D009369:Neoplasms / Q000188:drug therapy; D010602:Pharmacopoeias as Topic / Q000592:standards; D012955:Societies, Medical
chemical_list: D000970:Antineoplastic Agents